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Abstract Background Cancer disparities are a major public health concern in Canada, affecting racialized communities of Latin American and African descent, among others. This is evident in lower screening rates, lower access to curative, and palliative-intent treatments, higher rates of late cancer diagnoses and lower survival rates than the general Canadian population. We will develop an Access to Palliative Care Strategy informed by health equity and patient-oriented research principles to accelerate care improvements for patients with advanced cancer of African and Latin American descent. Methods This is a community-based participatory research study that will take place in two Canadian provinces. Patients and community members representatives have been engaged as partners in the planning and design of the study. We have formed a patient advisory council (PAC) with patient partners to guide the development of the Access to Palliative Care Strategy for people of African and Latin American descent. We will engage100 participants consisting of advanced cancer patients, families, and community members of African and Latin American descent, and health care providers. We will conduct in-depth interviews to delineate participants’ experiences of access to palliative care. We will explore the intersections of race, gender, socioeconomic status, language barriers, and other social categorizations to elucidate their role in diverse access experiences. These findings will inform the development of an action plan to increase access to palliative care that is tailored to our study population. We will then organize conversation series to examine together with community partners and healthcare providers the appropriateness, effectiveness, risks, requirements, and convenience of the strategy. At the end of the study, we will hold knowledge exchange gatherings to share findings with the community. Discussion This study will improve our understanding of how patients with advanced cancer from racialized communities in Canada access palliative care. Elements to address gaps in access to palliative care and reduce inequities in these communities will be identified. Based on the study findings a strategy to increase access to palliative care for this population will be developed. This study will inform ways to improve access to palliative care for racialized communities in other parts of Canada and globally.

Introduction Vaginal pain during intercourse and urinary incontinence are common complaints after gynaecological cancer treatments. Pelvic health physiotherapy treatments aim at optimising function through education on the use of vaginal moisturisers, dilation therapy programme and pelvic floor muscle training. Given that barriers such as time, travel, and costs are known to limit access to physiotherapy services, a virtual pelvic health physiotherapy programme may help to facilitate access. The primary objective of this study is to identify preferences, barriers and facilitators from individuals with gynaecological cancer regarding virtual pelvic healthcare survivorship care.Methods and analysis This patient-oriented, mixed-methods study will involve an online cross-sectional survey data (phase I) and qualitative data from a series of virtual focus groups (phase II). Phase I: an anonymous survey will be used to assess the demographics, health status, prevalence of urogenital symptoms, as well as knowledge, barriers and facilitators to pelvic health services of people with gynaecological cancer. A total of N=50 participants from Canada will be recruited through convenience and self-selection sampling. Phase II: a series of virtual semi-structured focus groups will be conducted with 10–15 participants on key topics related to virtual pelvic healthcare. Interviews will be audio-recorded and transcribed, from which key themes and quotes will be identified. An interpretive description qualitative method will guide analysis and implementation of results.Ethics and dissemination Approval from the Health Research Ethics Board of Alberta—Cancer Committee (HREBA.CC-21-0498) and of the CISSS Bas-Saint-Laurent (CISSSBSL-2021-10) have been obtained. Informed, electronically signed consent will be required from all participants. Results from this work will be published in a peer-reviewed journal and will be used to inform the development and implementation of a new Pelvic eHealth Module for individuals treated for gynaecological cancers. This module will be incorporated into a comprehensive educational and exercise programme offered by a web-based application.

Math story problems are difficult for many solvers because comprehension of mathematical and linguistic content must occur simultaneously. Across two studies, we attempted to conceptually replicate and extend findings reported by Mattarella-Micke and Beilock (2010, https://doi.org/10.3758/PBR.17.1.106) and Jarosz and Jaeger (2019, https://doi.org/10.1002/acp.3471). Mattarella-Micke and Beilock found that multiplication word problems in which an irrelevant number was associated with the protagonist of the problem (i.e., foregrounded in the text) were solved less accurately than problems in other conditions. Jarosz and Jaeger used similar materials but tested the more general inconsistent-operations hypothesis that association with the protagonist would interfere with multiplication whereas dissociation would interfere with division. They found partial support: When division problems were primed with dissociative scenarios, solvers made more errors, but they failed to replicate the associative findings for multiplication. In the present research, we conducted two studies (Ns = 205 and 359), in which we similarly manipulated whether irrelevant content was associated with or dissociated from the story protagonist. In these studies, we did not find support for either the foregrounding or inconsistent-operations hypotheses. Exploratory error analyses suggested that solvers’ errors were most often the result of calculation difficulties or inappropriate operation choices and were unrelated to the presence of associative or dissociative story elements. Our careful implementation of this manipulation and much greater power to detect effects suggests that the association manipulation in irrelevant text does not influence adults’ performance on simple math story problems.

Background: This study was set in 39 neighbourhoods involved in a government-funded regeneration programme called New Deal for Communities (NDC) that began in 1998. We tested whether or not different approaches to engage residents in decision-making in these areas had different social and health impacts. Methods: First, NDC approaches to community engagement (CE) were grouped into four types. We then assessed the impact of these types and whether or not their cost-effectiveness could be calculated. We used existing data from surveys and from NHS and government sources. New data were collected from interviews with residents of NDC areas and former staff. We have also made these data publicly available so that other researchers can assess impacts over a longer time period. Results: The four CE types included an empowering resident-led approach (type A), in which residents had a lot of control over decisions, and an instrumental professional-led approach (type D), in which CE was more often used to promote the priorities of public sector organisations. Type B was initially empowering but over time became instrumental and type C balanced empowerment and instrumental approaches from the beginning. There were few statistically significant differences in health and social impacts by CE type. However, when there were statistically significant differences, the results suggest that type A, and to a lesser extent, types B and C approaches may have had better outcomes than the type D approach in relation to levels of participation and trust between residents, control or influence over decisions, social cohesion and mental health. NDC areas with a type D approach were the only ones where residents’ ‘sense of control’ deteriorated over time. Residents of these areas were less likely to feel that the NDC had improved their area and to experience improvements in mental health. However, some aspects of cohesion and trust improved in type D areas. The findings of our economic analyses are mixed. It was difficult to cost engagement activities, measures of effectiveness were not robust and relating costs that could be calculated to specific measures of effectiveness was difficult. There were almost as many negative as positive scores, making the calculation of cost-effectiveness an arbitrary exercise. Conclusions: Our results are consistent with a theory that the greater the levels of control that residents have over decisions affecting their lives the more likely there are to be positive impacts. It is plausible that an empowerment approach to CE would help build trust and community cohesion, and that having a greater influence over NDC decisions could lead to more people feeling that the NDC initiative had improved an area. Conversely, our results are also consistent with a theoretical position which suggests that instrumental approaches, which try to engage residents in agendas that are not theirs, will have relatively little positive impact and that community cohesion and well-being may be undermined. The study has not produced firm evidence on the effectiveness of different approaches to CE. However, the findings do suggest that programmes involving CE will be more likely to have positive impacts if the approaches to CE are experienced as more empowering and less instrumental (i.e. less focused on the agendas of external agencies). Future methodological research is needed to develop better measures of empowerment at the collective level and more robust approaches to empowerment on health and well-being at the population level. Funding: The National Institute for Health Research Public Health Research programme.

Evidence-based practice requires access to practice guidelines, research articles, and other resources; however, home healthcare clinicians can face barriers when seeking health information. The purpose of this article is to provide home care clinicians with: a) free resources available on the internet, b) suggestions for searching and evaluating health information found on the internet, and c) opportunities for free continuing education for home healthcare clinicians.

The number of Asian immigrants has risen dramatically in recent decades, making them the fastest growing immigrant group in the United States. Home healthcare clinicians are expected to meet the healthcare needs of patients regardless of their ethnic or cultural background, but this can be challenging without a basic understanding of the patient's culture. This article is intended to provide information about the cultural traditions and health conditions clinicians may encounter when caring for patients and families who have immigrated to the United States from the top five Asian countries as determined by the U.S. Census, and concludes with resources that home healthcare clinicians can utilize when engaging in patient education.